Gnanakkan, Selvin Robin
Gnanakkan, Selvin Robin is an sole proprietor health care provider with primary practice located at 7122 N 59Th Ave Fl 1 , Glendale AZ 85301-2436. He recently has 2 registered licenses in different health care specialties including Eye and Vision Services Providers / Optometrist, Allopathic & Osteopathic Physicians / Ophthalmology. Eye and Vision Services Providers / Optometrist is his primary health care specialty. Gnanakkan, Selvin Robin can be contacted via phone (623) 931-1043.Contact Information
Primary practice address
7122 N 59Th Ave Fl 1
Glendale AZ 85301-2436
Phone: (623) 931-1043
Fax: (602) 535-3165
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 21201-875 | Wisconsin |
| Allopathic & Osteopathic Physicians / Ophthalmology | 207W00000X | TA1769 | Maryland |
| Eye and Vision Services Providers / Optometrist | 152W00000X | 1127 | Arizona |
Profile Details
| NPI number | 1104980846 |
|---|---|
| LBN Legal business name | Gnanakkan, Selvin Robin |
| Credentials | O.D. M.B.A |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Dec 20th, 2006 |
| Last updated | Mar 22nd, 2022 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1104980846 | NPPES |
| Arizona | MEDICAID | 900139064 |
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